Governor’s Summit follow-up:

Moving forward on a statewide and local level

Summary

On September 15th 2005, Governor Schwarzenegger held his much anticipated Summit on Health Nutrition and Obesity in Sacramento. The goal of the Summit was to bring business, industry and community leaders together from throughout the State to discuss the changes needed to improve nutrition and physical activity for all Californians. The Summit generated a number of successes, including “commitments of significance” on the part of business and non profit leaders, the Governor’s comprehensive Vision for a Healthy California and also the signing of three significant school food and beverage bills—SB12, SB965 and SB281 (See Key Accomplishments).

The Summit serves as a solid beginning for the Governor’s efforts to improve nutrition and physical activity environments throughout the state. Strategic Alliance has identified a number of next steps which build upon the Summit’s successes while also addressing its gaps and oversights. In addition to statewide government actions, each of the actions delineated should be mirrored by local governments.

The following actions are necessary to translate the summit into sustainable outcomes:

1. Greater and more significant commitments from industry that address the lack of availability of healthy, affordable foods and insufficient opportunities for physical activity and recreation on a neighborhood level;
2. Follow-up on the commitments including mechanisms for accountability;
3. A greater and more consistent focus on physical activity which includes physical education, parks and recreation, transportation, biking and walking;
4. A focus on nutrition that moves beyond schoolsand increases availability and accessibility of healthy foods on a neighborhood level to achieve equitable health outcomes;
5. Greater collaboration between different government departments and agencies—from Housing to Transportation to Food and Agriculture—to address issues of nutrition and physical activity in an interdisciplinary setting;
6. Implementation of effective and significant organizational practice changesto foster positive nutrition and physical activity environments within state government programs, buildings and state contracts;
7. Addressing current health inequities to ensure that improvements in nutrition and physical activity reach all communities equally, with a particular focus on reaching low-income and communities of color; and
8. Identifying concrete strategies for implementing each of the elements in the Vision for a Healthy California to ensure significant accomplishments of the desired outcomes.

Due to the immense importance of the Summit as a step towards a healthy California, Strategic Alliance has decided to issue this complete summary report, emphasizing concrete statewide and local level actions for moving the Governor’s Summit forward while also highlighting its significant accomplishments. We urge you to share this broadly. We urge you to share this broadly.

The documents highlighted in this report are available on the Strategic Alliance Website as well as the Governor’s website.

Statewide Actions:

The Governor’s Summit has the potential to serve as a strong beginning for a broad scale collaborative effort to improve health and wellbeing throughout the State. Strategic Alliance members can work together to maximize the impact of the Governor’s Summit. We ask that you share this report with your organizational and coalition members to help keep the momentum generated by the Summit moving in the right direction. We would also like to invite you to join us in our next interactive web conference, scheduled for mid January, which will discuss upcoming statewide actions in greater depth. Details of this web conference will be posted on the Strategic Alliance website and disseminated in upcoming newsletters. Outlined below are the highlights of points of action on a statewide level:

Broadening the legislative agenda

One of the hallmarks of the 2004-2005 legislative year was the passage and signing of SB12, SB965 and SB281 which will establish some of the strongest nutrition standards in the country for school food while also introducing more fresh fruits and vegetables in school meals. The significant steps in promoting healthy nutrition environments offer the opportunity to do the same for physical activity environments. Discussions are currently underway amongst advocacy groups on specific opportunities to advance physical activity and physical education, in addition to nutrition, through statewide legislation for the upcoming legislative session. For information on past and future nutrition and physical activity legislation, please visit the California Center for Public Health Advocacy as well as the Strategic Alliance’s policy page. 

Monitoring the Commitments of Significance

First Lady Maria Shriver, who has played a key role in the summit, has stated that she is going to ensure that there is follow through on the commitments of significance and that there will be follow-up discussions with those businesses who have not yet made commitments to urge them to do so. A committee that is comprised of Harold Goldstein of the California Center for Public Health Advocacy and Strategic Alliance Steering Committee member, Secretary of Health and Human Services Kimberly Belshé and Safeway Executive Vice President Brian Cornell, has been established to monitor the commitments of significance. The exact format of the monitoring efforts is still to be determined and will be shared as soon as the information becomes available.

Generating new commitments of significance

In addition to recognizing the responsibility of the Schwarzenegger administration in monitoring the actual commitments, Strategic Alliance members can also urge the administration to proactively pursue specific commitments that are still needed—such as opening more supermarkets in low income and underserved neighborhoods.  Strategic Alliance is currently analyzing the gaps between the actual commitments made and the strategies called for in our Taking Action for a Healthier California document; we will disseminate our analysis shortly.

Organizational Practice Change

The Schwarzenegger Administration, through the California Health and Human Services Agency is committed to changing organizational practices in relation to nutrition and physical activity, including marking walking paths for employees, opening up stairwells and reviewing the foods that are served on their sites. It is anticipated that the specific organizational practice changes will also go beyond those listed and we will keep members of the Strategic Alliance apprised of these as they become available through the newsletter and our website.

Engaging Diverse Agencies and Sectors in Promoting Nutrition and Physical Activity

Although the Summit included representatives from state government departments and agencies—including Food and Agriculture, CA State Parks, and Transportation and Housing—there were no opportunities present to fully engage these departments and agencies. Strategic Alliance is calling for a more interdisciplinary and collaborative approach to addressing nutrition and physical activity by including the active engagement of non-traditional “players” and agencies. Although it makes sense for nutrition and physical activity efforts to be coordinated through the Department of Health and Human Services, it is important to identify concrete roles that other departments and agencies can also play in order to move the agenda forward.

Local Actions

Actions at the local level serve as important levers and tools in creating sustainable improvements in nutrition and physical activity environments. Often the policies or practice changes at the local city, county or even neighborhood level have the potential to bubble over and initiate change in neighboring communities. There are a number of important actions on the local level that you and your organization or coalition can take to make sure that momentum created by the Governor’s Summit doesn’t end.

Local monitoring of commitments of significance

Although the commitments of significance will be monitored as they take place on a statewide level, Strategic Alliance members are encouraged to monitor these commitments on a local level. Please let Strategic Alliance know if the businesses that made commitments actually implementing them wherever possible. Secondly, as a Strategic Alliance member you can also take steps to evaluate the impact that particular commitments are actually having (or not having) as they apply to creating opportunities for people to eat healthy and be physically active. These local evaluations can serve to really put the corporate promises into perspective. The results of these local evaluations can consequently be shared with Strategic Alliance and the Governor by contacting Sana, sana@preventioninstitute.org  

Building upon the commitments of significance

Strategic Alliance members are further encouraged to view the commitments of significance made thus far as initial commitments by building upon them however possible. One concrete action you can take is to identify what further actions and commitments are needed on a local level and then work with businesses and non-profits to make these happen.

Additional momentum building actions on the local level

1. Endorse the Taking Action Recommendations! And encourage others to as well, especially your local government bodies. The San Francisco Chronic Disease Consortium, for example, obtained an official endorsement of Taking Action by the San Francisco Board of Supervisors.  Click on the Taking Action link  for the Taking Action Toolkit including a presentation you can use to present Taking Action for endorsement and a model resolution for local governing bodies.
2. Prioritize one local environmental change for advocacy efforts. Visit the Environmental Nutrition and Activity Community Tool (ENACT) to identify specific strategies to improve nutrition and physical activity   
3. Engage local government. Urge local government to endorse the Taking Action Recommendations and to engage in organizational practice change
4. Support statewide policy efforts to improve eating and activity environments. Visit the California Center for Public Health Advocacy for updates on statewide policy.
5. Participate in Media Advocacy
1. Join the Rapid Response Media Network whichoffers an exciting opportunity to engage with local media and insert the environmental and policy perspective on nutrition and physical activity promotion into the public discourse. As a member of the Network, you will receive guidance for crafting letters to the editor, op-eds and other interactions with the media. Strategic Alliance will generate and distribute talking points and framing analysis to guide responses to major news stories/industry actions and the like.  (email sana@preventioninstitute.org for more details and to join)
6.  Keep expanding the Network of supporters. Encourage your colleagues to join the Strategic Alliance.

Governor’s Summit on Health Nutrition and Obesity Complete Synopsis

Key Summit Accomplishments

• “Commitments of significance” made by industry and non-profit organizations towards improving nutrition and physical activity through organizational practice changes, changes to product lines, financial investments, urban and built design, and much more. 
• Governor’s Vision for a Healthy California is a set of recommendations that move beyond only calling for individual responsibility and action by also calling for marketing only healthy foods to children under age 12 as well as neighborhood environments that provide easy and affordable access to healthy foods options and for recreational and physical activity. Many of the recommendations directly reflect the recommendations in Taking Action, which was shared with the governor and the planners of the summit. The Vision is broadly reflective of an administration that understands the role of the environment in creating the conditions needed to eat well and be physically active. 
• Signing of SB12, SB965 and SB281 which will establish the strongest nutrition standards in the country for school food while also introducing more fresh fruits and vegetables in school meals.  SB12 and SB965, authored by Senator Martha Escutia, limit the amount of calories and sugars in school foods (SB12) and extend the ban on the sale of sodas to high school (SB965). Both of these bills were signed over the strong objection of the beverage industry, according to Senator Escutia.  SB281 by Senator Abel Maldonado will allow for $18.2 million towards fresh fruits and vegetables in school meal programs.

Attendees & agenda

During the opening session of the summit, Governor Schwarzenegger challenged “leaders in government, business, education, medicine and parenting to continue the work we have begun today to make California the nation's model for health, nutrition and fitness.” According to California Health and Human Services Secretary Kim Belshé as well as reports from attendees, the one day event successfully brought together a broad group of partners, including “some of the best minds from California business, public health, academia, community groups and government”.  Not only were advocates for nutrition and physical activity well represented at the summit, but attendees also included representatives from state government departments and agencies, including Food and Agriculture, CA State Parks, and Transportation and Housing.

Highlights from the day’s agenda included comments by Secretary Belshé and Dr. Robert Ross, president of The California Endowment, who sponsored the summit. Dr. Ross noted that the summit was “the most pivotal 6 hours in the state’s public health history in the last 20 years.” A number of celebrities spoke during the summit, including Dr. Mehmet Oz, author of YOU: The Owner's Manual, who underscored the public health crisis by bringing atherosclerotic organs, and a container full of fat. Dr. Phil McGraw served as one of the keynote speakers, noting that while it is important to receive education about nutrition and physical activity, “pamphlets at the checkout stand is not education.”

Commitments of Significance

A hallmark of the day came in the form of the “commitments of significance” made on the part of industry and non-profit organizations. Commitments include:

• California Association of Health Plans is committing $30 million over the next three years through its 35- member health plans, reaching 21 million health care consumers.  Of participating members, one of the most significant commitments is from  Kaiser Permanente who will “commit $18.5 million over the next five years to community based efforts to promote healthy eating and active living”
• Lewis Operating Corporation is extending their  “commitment to developing communities that promote healthy and active living to new communities in Riverside County”,  and will “design an extremely pedestrian-oriented community plan”
• American Academy of Pediatrics is committing to changing their organizational practices including providing “doctors and family practitioners with tip sheets for parents and kids about obesity prevention” and information for doctors on how to talk about obesity with parents and patients. In addition, the American Academy of Pediatrics will be sending a letter to every doctor in the state co written by Strategic Alliance member Dr. Francine Kaufmann and First Lady Maria Shriver urging doctors to adopt a broad environmental perspective in their approach to the causes of poor nutrition and physical inactivity.
• Safeway which will increase access to healthy foods by expanding their ready to eat “Eating Right” product line,  and “integrate natural and organic foods into every aisle, group healthy products, and make healthier option sections more readily identifiable”
• Ruiz Foods which will eliminate trans fats from all products and “develop a new product line that meets child nutritional guidelines set by the Food and Drug Administration”.

Missed Opportunities

There were some clear missed opportunities during the summit. Although physical activity was highlighted along with nutrition, the predominant physical activity focus was on individual responsibility. The importance of biking, walking and mass transit was barely mentioned during the summit. There was also inadequate emphasis on the need for quality physical education programs in schools or the inequities that exist in terms of access and location of parks and open spaces. There was also insufficient focus on health disparities in general and the conditions that create these disparities. For instance there was little mention of safety as it relates to physical activity. Neighborhood inequities including inadequate supermarket access or the general needs of people with limited resources were not elaborated on. The commitments of significance did not include improving access to supermarkets selling healthy and affordable foods in underserved neighborhoods. Lastly, although key government agencies and departments--from Food and Agriculture to CA State Parks to Transportation and Housing-- each had representatives attending the summit, the Summit did not provide a significant opportunity for these different agencies to be actively engaged in the process established by the Summit.

The Summit establishes CA in clear leadership on t his important health issue and we look forward to the follow through that will build upon these efforts.

The Strategic Alliance, is reframing the debate on nutrition and physical activity--from a focus on individual choice and lifestyle, towards one of environment and corporate and government responsibility.

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